1. Technical Field
Apparatuses, systems and methods for ensuring compliance hand sanitizing protocols are disclosed. More specifically, this disclosure is directed toward apparatuses, systems and methods for monitoring medical and employee compliance with hand sanitizing protocols.
2. Description of the Related Art
Nosocomial infections, also commonly referred to as hospital acquired infections (HAIs), are infections which may be acquired during a patient's stay in a hospital. HAIs are defined as infections that are acquired 48 hours following admittance into, or 30 days following release from a hospital. HAIs are prevalent throughout the United States; 1.7 million cases of HAI are documented in the US every year. Among the documented cases, 99,000 cases have resulted in death. In addition to this devastating annual death toll, HAIs are also costly from a financial standpoint; costs associated with nosocomial infections reach about $17 billion dollars' annually in the US alone.
Hospitalized patients may be very weak, and are thus more susceptible to infection because their immune systems may be compromised due to the various diseases or conditions from which they are recovering. In fact, studies show that about 1 in 20 patients (−5%) in a US hospital may acquire an HAI during their stay. Furthermore, among critically ill patients in a US intensive care unit (ICU), rate of infection can rise to about 18%. On average, a patient's stay may increase by 12 extra days as a result of an HAI. If the patient acquires multiple HAIs, the average length of stay can be prolonged to about 45 days. With the average cost per day in an American ICU exceeding $3,000 per day, acquiring just one HAI and an additional 12 days in the ICU increases the cost of a hospital stay by over $35,000. If a patient acquires multiple HAIs, the average increase in cost may exceed $1 million. Thus, there is an urgent need to address the rampant spread of HAIs.
HAIs may be transferred to patients via various means in the hospital, but the most common means may be by direct contact between hospital staff and patients. Specifically, because healthcare personnel handle patients carrying different diseases throughout the day, hospital personnel can inadvertently spread residual disease-causing particles merely by making contact with other patients. Additionally, infectious pathogens may be transmitted by contact with contaminated surfaces, also known as fomites. Consequently, hand sanitization has been shown to be one proven method to reduce the spread of diseases such as HAIs due to direct contact. Indeed, the lack of appropriate hand hygiene in US hospitals is believed to be the leading cause of HAIs.
There are several ways by which one may sanitize one's hands. However, one of the most common solutions involves the use of an alcohol-based hand sanitizing solution, or “hand sanitizer”. These solutions typically include from about 60% to about 95% alcohol (ethyl alcohol) by volume in the form of a liquid or gel. Hand sanitizers are commonplace throughout hospitals and are used in other locations that are frequented by large numbers of people such as dental offices, business offices, grocery stores, shopping malls, etc. Hand sanitizers are shown to kill 99.5% of transient micro-organisms, when applied to the hands for 15 to 30 seconds. Because of the alcohol content, hand sanitizers have also been found to be more effective than soap and water at eradicating a wide array of micro-organisms.
Using alcohol-based hand sanitizers has been shown to effectively reduce the incidence of HAIs. A study revealed that incorporating alcohol-based hand sanitizers into hospitals reduces HAIs by between about 30% and about 36%. Unfortunately, while hand sanitizers are sufficiently abundant and effective, hospital personnel do not utilize them with sufficient frequency or as required by hospital protocol. Thus, one way to combat HAIs is to target the widespread problem of noncompliance with hand sanitizing protocol. One study conducted by the Society for Healthcare Epidemiology of America found that compliance levels among US healthcare personnel may be as low as 19%. Further, compliance values rarely exceed 40%. As the result, various nationwide organizations have recently sought to develop interventions that would ideally enforce consistent adherence to proper hand sanitization protocol, and effectively raise compliance levels among healthcare workers.
One strategy involves education of healthcare employees in the form of lectures, demonstrations, written materials, and the like. Further, some institutions have engaged in renovations in order to facilitate compliance. For example, renovated hospitals and new hospitals may include the conspicuous placement of hand sanitizer dispensers and personnel protective equipment (PPE) on or in walls next to each room in an ICU or the conspicuous placement of sinks or wash stations in hospital rooms and/or hospital hallways in order to promote increased hand sanitizing compliance.
Feedback to healthcare employees is another technique utilized in order to increase hand sanitization compliance. Such feedback may consist of the observation and evaluation of a healthcare employee's sanitization performance and compliance with appropriate sanitization practices. Reminders may also be utilized as a form of feedback in the form of safety labels, warnings and other postings. Reminders address the tendency of healthcare employees to forget or become too distracted to comply with hand sanitization procedures. Further, the introduction of negative reinforcement in the form of punishment, or positive reinforcement in the form of incentives, has been demonstrated to convey significant effects upon behavior.
The American Society for Microbiology compiled a variety of national studies regarding compliance techniques, in order to determine the relative efficacy of (1) education with feedback, (2) feedback alone, (3) education only and (4) reminders only. The results of this study are shown in FIG. 1. As shown in FIG. 1, the highest increase in compliance (57.3%) resulted from an approach that integrates education and feedback, followed by feedback alone (46.2%). Methods involving education alone and reminders alone led to the least increases in compliance (13.4% and 8.00%, respectively).
However, improvements to the presently existing compliance strategies are still urgently needed. Specifically, although education with feedback, feedback, education and reminders increase compliance levels, the increase or rise is not sufficient because only 100% compliance may provide assurance that the transmission of HAIs via direct contact are being inhibited as much as possible. Further, the currently employed strategies exhibit a duration-limited impact upon compliance that is not reflected in FIG. 1. Regularly repeated feedback can lead to the most sustained increase in compliance behavior, while reminders provide a modest rise in compliance levels, but only in the short-term. Education alone leads to the least sustained effects upon compliance.
Accordingly, improved apparatuses, systems and methods for ensuring compliance with hospital hand sanitization protocols are needed.